Percutaneous balloon atrial septostomy in infants with transposition of the great arteries

Abstract

Initial experience with PBAS in early management of neonate with TGA is described. Standard percutaneous techniques were used and modified by a series of dilations designed to introduce a septostomy catheter into the femoral vein. Thirty infants with TGA were catheterized, and PBAS was accomplished in 25. The mean aortic oxygen saturation rose from 55 to 72 per cent. Twenty-four infants were clinically palliated for at least 3 months; however, five required pre-elective surgery thought due to inadequate atrial mixing. No severe complications followed PBAS. Twenty-three patients underwent follow-up catheterization, in 17 through the vein used for PBAS. When compared to patients with TGA who had cutdown insertion of balloon septostomy catheters, the group treated by PBAS was similar in patient material, and successful septostomy. Those ballooned percutaneously had fewer complications and required slightly less time for the procedure. We feel that PBAS is a relatively easy and safe palliative procedure when performed in an infant with TGA. It should be considered by all those performing percutaneous diagnostic catheterization in infants and children.